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Household medical waste is waste that is generated as a result of health care activities in the home. It may include bandages, hypodermic needles and lancets, among other things. The primary focus of this guidance is the management of potential infectious waste.

Should I be concerned about the handling of medical waste from my home?

In general, medical wastes generated in the home are not a serious health concern. However, an exception could be when the medical waste is also an infectious waste. According to Title 132 – Integrated Solid Waste Management Regulations, an infectious waste is any medical waste that is capable of causing disease in another human being if that person comes into contact with the waste. This may include wastes that are contaminated with blood or other body fluids from people who have infectious diseases. For a full regulatory definition of infectious waste see Title 132, Chapter 1, §053 et seq. Infectious diseases, like HIV/AIDS and Hepatitis B, are serious and can be fatal. That is why caution is necessary when handling any infectious wastes in your home. Steps should also be taken to protect the people who handle your household waste after it leaves your home.

What am I required to do with my household medical waste?

Household medical waste is considered a solid waste and must be disposed in a permitted municipal solid waste (MSW) landfill like any other type of household waste. If you think the medical waste you are generating in your home is infectious you should either treat the waste in a way that makes it no longer infectious or properly package the waste to reduce the risk of exposing others to possible infection. Household medical waste can be added to your general household waste which is picked up by your garbage hauler or otherwise transported to a permitted MSW landfill. A health provider with access to proper infectious waste management may also accept your household medical waste. Note there is no obligation for any health provider to accept any medical wastes not generated at their own facility.

How do I properly package infectious wastes for disposal?

The department recommends the following guidelines for packaging, transporting, or disposing infectious wastes generated in the home:

Place the waste in a rigid or semi-rigid, puncture-resistant and leak-proof container;

Do not mark or label the container in such a way as to divulge the contents;

Tightly close or seal the container; and

Ensure the outside of the container is free from contamination.

From a practical standpoint, any type of sharp medical wastes, such as needles or lancets, should be placed in a puncture-resistant container whether it is infectious or not. You may wish to obtain a sharps container designed for the purpose of sharps disposal; often they have a one-way opening and come with warning labels. This will protect family members and waste handlers from possible cuts or punctures.

How do home health care nurses need to handle medical wastes?

Any medical waste that is generated in the home should be handled as described above or transported to the clinic/hospital for disposal. Medical waste from single-family homes collected by a home health care agent can and should be handled in the same manner. However, medical waste generated in hospitals and medical clinics do not qualify for the household waste exemption and must first be rendered non-infectious by incineration, autoclaving or other treatment methods before disposal at any solid waste disposal area. Most clinics and hospitals use a commercial medical waste treatment service.

How about nursing homes or assisted living facilities?
The department views individual quarters where persons routinely reside as a “household” and medical waste generated from those quarters is considered Household Waste as defined at Title 132, Chapter 1, §049. Medical waste generated at a nursing home or assisted living facility in common areas such as nursing stations, examining rooms, or meeting rooms/hallways is not considered household medical waste and cannot be placed in the general trash.

Hospital rooms are not considered “households” by the department. A hospital room, as pleasantly designed as some might be, is not meant to be a residence in the way a nursing home or assisted living resident room is. They are meant for the express purpose of delivering medical treatments, procedures, or medical observation. Some assisted living facilities are closely associated with a connected hospital. If this is the case, the two facilities are separate as far as “household” medical waste generation is concerned. Tracking of medical waste in a dual-purpose facility may be necessary to ensure proper disposal.

Hospital infectious waste?

Hospitals are not allowed to dispose of infectious waste to a MSW landfill unless it is first rendered non-infectious (Title 132, Chapter 13, §004). This is, again, where most facilities hire the services of a commercial medical waste treatment service that will incinerate, autoclave, or otherwise render the materials non-infectious before disposing of them in a MSW landfill.

What about old or unused drugs?

A recently assessed group of pollutants in our aquifers and waterways are discarded prescription drugs. Exposure of fish and wildlife to some of these complex pharmaceuticals, even in diluted form, can be tragic to observe and may affect the environment for generations. Never dispose of them down a sanitary sewer or septic system! See the NDEQ Guidance Document – “Medications and Infectious Waste Disposal” for better and correct ways to dispose of pharmaceuticals. This can be accessed at the NDEQ web site. Keep in mind the best way to manage pharmaceuticals is to procure only the amount you’ll need and following doctor’s ordersuse the pharmaceuticals for their intended use until fully consumed.